Weight Regain After Surgery
“Weight regain after surgery. Why does it happen?”
I often get asked by patients and their families at the pre-op visit “Why do people regain weight after surgery”? So, why does this happen? While observing a few older patients (some from our practice and some from others), I have noticed several poor dietary behaviors develop, such as eating in between meals, overeating, and eating wrong combinations of foods. It is never a good practice to snack in between meals. This will lead to a great amount of calories. Also, I would find that patients would choose high carbohydrate snacks, such as starches and simple sugars. Both of these lead to a lack of satiety and increased hunger as they are quickly digested and burned. High carbohydrate snacks also lead to hypoglycemia in the bypass patient with nausea, sweats, and dumping like symptoms a couple of hours later. If the calorie load is higher than the need, then the remainder is stored as fat. Folks tend to snack for a variety of reasons. Examples could be stress, loneliness, and boredom. For those who cannot seem to understand why they overeat, I recommend psychological counseling. A licensed psychologist can take a closer look into the causes behind the overeating and help the person find other alternate forms of stress relief. For those where boredom is an issue, I recommend taking up a new hobby. If loneliness is an issue, try joining a support group, working out at a fitness center, chatting online or volunteering time and services. All of these things will expose one to many different and interesting people and will help foster friendships.
Overeating at meal times is another cause of weight regain. Several things can lead to this, but I will only name a few. To avoid overeating at restaurants, half the portion served and immediately ask the server for a box. Not only will one be cutting portion sizes to a normal size, there will be leftovers for another meal. If an extended time is spent socializing, get refills on non-caloric beverages such as decaffeinated tea, coffee, and lemon water instead of opting for more high caloric drinks such as cocoas, smoothies, and alcoholic beverages. When dining at home, fill your plate from the stove. Research has shown that people are less likely to overeat if extra food is kept in cooking ware and not served at the table. Finally, if taking too much time to eat is a problem, set a timer for 20-30 minutes for each meal. This is sufficient time to allow one to eat and prevents excessive intake.
Finally, proper food combinations are essential to weight loss, weight stability, and satiety. Many patients have heard our dietitian say, “There are no wrong foods, just wrong combinations of them.” For each meal, make sure that 50-70% is protein. Research has shown that a higher protein diet promotes weight loss. Because proteins make us feel satisfied longer. Proteins come from a variety of sources: low fat dairy products, eggs, lean meats, seafood, legumes, nuts, seeds. In addition to protein, choose low fat and low carbohydrate sides such as dairy products, fruits, vegetables, whole grain snacks, and whole grain pastas. Limit starchy vegetables such as potatoes, corn, and peas. Many empty calories and fat grams come from some of the things we use to prepare our foods such as butter, dressings, sauces, and condiments. A few suggestions would be using spritzers instead of dressings for salads, opting for light sour cream in place of butter for a potato. One may also want to consider diluting marinades or asking for sauces on the side if eating out.
Let’s get the new year off to a good start with good eating behaviors and lifestyle choices!
Kristine Vanhoose, FNP-BC